Why Does A Knee That Was Sprain Still Hurt After A Few Weeks
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Problem: Patella Or Kneecap Pain
When working properly, your patella should glide straight up and down as you extend your leg. But sometimes the kneecap slides slightly off track and rubs against the bone and cartilage nearby. This can lead to pain and swelling in front of the knee and behind the kneecap. You can also hear a crackling noise.
A Meniscus Or Ligament Tear
This is common in people playing sports that involve sudden changes of direction. Soccer, basketball, and tennis are a few good examples.
The meniscus is a shock-absorber disc inside the knee joint. It also protects your bones so they dont rub together.
Conversely, a ligament is a strong, thick band that helps stabilize the joints.
If youve torn any of them during a sports activity or your daily life, you might feel:
- A cracking or popping that wasnt there before.
- A loud pop at the moment of injury.
- Pain, swelling, difficulty walking.
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Could I Just Have Arthritis
Sure, especially if youre an older runner over the age of 55. Typical arthritis is due to wear and tear and you may be at a higher risk of developing arthritis if youve experienced a traumatic injury to the knee in the past.
Visit your doctor and get an x-ray to confirm the diagnosis. But dont worry, just because you have some arthritis doesnt necessarily mean youre experiencing any pain. Degeneration of cartilage in the knee doesnt always cause pain while running.
Defer to your doctors prescribed treatment of arthritis, as it will be different from PFPS.
Anterior Knee Pain: The Basics
Pain in the front of the knee or anterior knee pain can affect people in all age groups. Approximately 25% of people will suffer from pain in the front of their knees at some time in their lives. I have seen teenagers who can longer participate in sports, and I have 70 years olds who can no longer walk downstairs without fear of their knee giving way. Why is our kneecap or patella so prone to bothering us like this?
The cause of anterior knee pain might vary based on your age, level of activity, and your chosen sports. We can see people who are inactive and suffer from pain in the front of the knee, and we can also see people who are highly trained and disciplined who are suffering from pain around the kneecap. The majority of people who have pain in the front of their knee do not recall any injury.
In the majority of cases of anterior knee pain, we do not find anything significant wrong with your X-rays or MRI scans. It seems that the pain in the front of the knee is often due to imbalances, weakness patterns, movement patterns, and complex issues that can take a while to figure out. Yes, some of you might have a cartilage defect or some early arthritis in the front of your knee but believe it or not, the majority of you will have pretty normal-appearing imaging studies. That has led to a significant change in our approach to anterior knee pain over the years.
Anterior knee pain is particularly common in young women and many runners.
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Are Cracking Knees A Sign Of Osteoarthritis
Not on its own.
It can be a sign of knee osteoarthritis if its associated with at least 2 of the following:
- Knee pain in most days for the last month, that gets better with rest.
- Loss of range of motion.
- Morning stiffness on the knee.
- +50 years old.
If so, go to a doctor and physical therapist to plan your treatment.
How To Prevent Knee Pain At Night
There are means to help you reduce knee pain at night, such as resting the knee and applying heat or ice to the area before heading to bed. You may also consider taking an over-the-counter pain medication to reduce inflammation prior to going to sleep.
During the day, take the time to exercise the leg muscles in order to strengthen the surrounding muscles of the knee for greater support.
If knee pain at night persists, you will then want to speak to your doctor to uncover exactly what the underlying issue is and get into any treatment plan they may put you on.
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Should I Get A Bone Scan Or Mri
In all my research, personal experience, interviews, and coaching experience, Ive never found mention of MRI or CT Scans being helpful in diagnosing Patellofemoral Pain Syndrome.
However, bone scans have shown to be worthwhile for chronic sufferers who want a more definitive diagnosis. If the patella is truly distressed or tired like we discussed in the previous section, it will show up on a bone scan. A bone scan works when youre given an injection with a tiny amount of radioactive material. It shows up on the scan and spreads wherever your blood goes .
Bone scans are expensive and Id ask your doctor if its appropriate if you have chronic PFPS. My research has concluded that this type of scan can confirm a PFPS diagnosis and help isolate the overused tissue.
Tips For Healthy Knees
- Regular exercise can strengthen your legs and knees. Exercise with weights or resistance bands — or do bodyweight moves, like squats and lunges — at least twice a week. Walk up stairs or hills, or ride a stationary bicycle to build muscle to support your knees.
- Warm up before you exercise. An intense workout with cold muscles and joints can cause injury.
- Keep flexible. Before exercise, try dynamic stretches, in which you move a muscle through a full range of motion. After exercise, do static stretches, where you hold a stretch for 30 seconds. This helps prevent injury. Regularly stretch the muscles in the front and back of your thigh .
- If youâre already exercising, slowly work up to harder, longer workouts.
- Wear shoes that fit right and are in good condition.
- Stay at a healthy weight. Youâll reduce stress on your knees. Being overweight is a major risk factor in developing early arthritis of the knee.
âThe best thing is to keep the muscles around the knees strong,â McAllister says.
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Complementary And Alternative Therapies
A number of mind-body therapies may be used to treat knee pain. These include:
- Acupuncture
- Tai chi
These are especially common for knee osteoarthritis.
The once-popular supplements glucosamine and chondroitin have fallen out of favor for knee osteoarthritis. That’s due to a lack of scientific proof. Always talk to your healthcare provider before taking any supplements or medications.
Common Conditions That Cause Sciatica
Conditions that are known to cause sciatica include:
L4 radiculopathy:
The compression of the L4 spinal nerve root causes sciatica. A herniated disc or spinal stenosis contributes to this. You may also get pain in your thigh and calf.
Tight hamstring:
These are the muscles at the back of the thigh. When muscles are tight, back stability is reduced. Therefore, the curvature is altered. This increases back stress and causes sciatica. Pain can then radiate to the knee.
L3 radiculopathy:
A herniated lumbar disc causes L3 nerve compression. This part of the spine is in the lower back. This can cause pain in the knee as well as weakness. Pain can also be felt in the groin, hip, and thigh.
Patellofemoral stress syndrome:
This is a condition where the kneecap rubs the thigh bone. This is also known as runners knee. You will feel a burning sensation at the edge of the kneecap. The pain will not be felt elsewhere in the leg. But, it is often mistaken for sciatica pain.
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What Is Wear And Tear Arthritis
How can you tell if you have osteoarthritis?
If you have pain inside your knee, under your kneecap,especially when kneeling, squatting or going up and down steps, its usuallywear-and-tear arthritis, says Dr. Nickodem.
Cartilage, the cushioning betweenbones, deteriorates throughout life. It can erode more quickly in some peopledue to injury or genetics. As cartilage thins, your bones begin to rubtogether, causing pain, swelling and stiffness.
Sometimes the level of pain does notalways correlate to the severity of the condition.
What Causes A Clicking Sound In The Knee
The knee joints can be noisy. Knee clicking, popping, or crunching sounds are common and typically no cause for concern. Theyre often the result of soft tissue stretching over the joint or bony protrusions.
But if you experience knee clicking with pain or swelling, it may indicate a serious injury or osteoarthritis.
Your knee joint sits where the femur , tibia , and a protective shield called the patella meet. Since the knee bears most of your body weight, its cartilage, ligaments, and tendons are especially vulnerable to everyday wear and tear.
Two pieces of cartilage act as shock absorbers, providing a cushion between the femur and tibia bones. These are the menisci.
Other essential parts of the knee include the articular cartilage, the collateral and cruciate ligaments, and the quadriceps and patellar tendons.
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Mayo Clinic Q And A: Pain After Knee Replacement Surgery
DEAR MAYO CLINIC: It has been months since I had knee replacement surgery, but my knee is still hurting. Can anything be done at this point, or does the surgery just not eliminate pain in some patients?
ANSWER: Although its uncommon, a small percentage of patients continue to have chronic knee pain after knee replacement surgery. But when that happens, you dont have to just put up with the pain. Have your situation evaluated. Several additional treatment options may ease chronic knee pain after knee replacement.
Knee replacement surgery, also known as knee arthroplasty, is one of the most common orthopedic surgeries performed today. It is most often used to repair joint damage caused by osteoarthritis or rheumatoid arthritis that causes severe knee pain and makes it hard to perform daily activities.
During knee replacement, a surgeoncuts away the damaged bone and cartilage from your thighbone, shinbone andkneecap, and replaces it with an artificial joint. For most people, kneereplacement significantly improves mobility and relieves knee pain. But in somepatients, the pain persists after surgery.
Your first step in dealing withongoing knee pain in this situation is to make an appointment to see thesurgeon who performed your knee replacement. He or she can evaluate your kneeand check for possible complications from the surgery, such as an infection ora problem with the artificial joint.
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Related Articles
How Do I Stop My Knees From Popping
This depends on the cause of popping.
Try these ideas if the knee crack didnt start during or after a trauma, and theres no pain associated with it:
- Change the position of your feet, or bend a little more your hips. This could reduce the popping if it comes from rubbing tissues or the stick-slip phenomenon described above.
- Strengthen your legs, preferably under the guidance of a personal trainer.
- Walk more throughout your day.
For some people, the popping doesnt go away no matter what they try. If its painless, this should be normal.
However, knee pops can also be linked to a number of pathologies. These noises will stop when you manage the underlying cause.
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Why Do My Knees Hurt After Running
Why do you run? Because it feels good. Because it relieves stress. Because it enables you to eat cake. I get that, because running is also important to me. Im a 32-time marathoner who knows how frustrating it is to be injured. Its the reason I became a sports doctor. Ripping my anterior cruciate ligament playing football when I was in medical school was devastating, but it was the single most important event to influence my work. Its what drives me to help my patients. Almost every day I treat runners with achy knees. Many are freaked out: can I still run? Will I have to switch to swimming? Thankfully, most knee problems wont keep you off the road for long. Heres what you need to know about common knee injuries.
Less Common Causes Of Knee Pain
Less-common causes of significant knee pain include conditions and injuries. Injuries include:
- Dislocated kneecap: Causes are sharp blows to the knee or twisting. Severe pain in the front of the knee plus buckling, slipping, or catching during movement.
- Kneecap fracture: Causes are a direct blow or falling onto the knee. Pain, difficulty straightening the leg, bruising, and swelling can occur. Sometimes there’s visible deformity.
Conditions include:
- Gout: High uric acid levels form sharp crystals inside the joint. Affects the knee, hip, fingers, and especially the big toe. Pain can be severe.
- Plica syndrome: Irritation of the synovium . Pain is in the middle and front of the knee. Worsens with inactivity or squatting, running, or kneeling. The knee may pop when bent.
- Osgood-Schlatter disease: Strikes after growth spurts in kids between 9 and 14. Pain is in the front of the knee. It improves with rest and worsens with activities like running and jumping.
- Osteochondritis dissecans: In children, lack of blood supply weakens the bone and cartilage. The knee may separate from the underlying bone. Causes pain with activity.
- Knee joint infection: Causes significant pain, swelling, warmth, painful movements, and fever. It may result from a bacterial infection in the bloodstream.
- Bone tumor: Very rarely the source of knee pain. Symptoms include fever, unintentional weight loss, and pain that’s worse at night.
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How Can I Naturally Lubricate My Knees
Foods high in healthy fats include salmon, trout, mackerel, avocados, olive oil, almonds, walnuts, and chia seeds. The omega-3 fatty acids in these foods will assist in joint lubrication. Water can assist in joint lubrication. Make sure you drink plenty of water each day to ensure that your joints are lubricated.
You Neglect Soft Tissue Work
Last, but certainly not least, your knees will bother you if the soft tissue that attaches to them is gritty. Thats the not-so-scientific term for having knots or adhesions in them.
If the tissue around the knee is not doing so hot, it can negatively impact overall movement. But this is a chicken-or-the-egg argument, and for the most part, I find that crappy movement causes crappy tissue.
All of the other factors above create gritty tissue. And once the tissue is gritty and left unaddressed, it can create unwanted tension on the knee.
Typically, we are talking about the quads and the IT band. However, the hamstrings, adductors and calves can also be factors. When these tissues are not optimal, not flossing well, and impeding on nerves that run through them, you will likely experience pain at the knee.
For this reason, it is imperative to take care of soft tissue work before and after training. Soft tissue care should become part of your daily routine, and be looked at as a preventative measure and an easy way to enhance performance and decrease your risk of pain or injury.
If you have the ability to work with a practitioner who has solid manual skills such as a physical therapist or massage therapist, this can also help with addressing the soft tissue.
The takeaway here is that you must ensure that the soft tissue around the knee is optimal if you truly want to prevent knee pain and enhance performance.
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Your Core And Butt Are Weak
The movement flaws above typically occur because of weakness at the core and glutes/hips.
Very rarely do I find an athlete who falls into the patterns above who does not have a strength deficiency in one or both of these areas.
When your core is weak, or does not activate at an optimal time during movement, the hip shifts out of place. This is directly linked to the hip shift movement flaw.
What also happens is that when the hip shifts, the glutes are no longer in a position thats conducive for them to turn on with any degree of strength. They are in a suboptimal alignment to create high amounts of force.
When the glutes dont fire well, and/or are not strong enough, the upper leg will rotate internally, causing the knee collapse or valgus. As we know from above, this is not a good position for the knee.
So what can you do?
Try the following exercises to first get the core activated and then the glutes turned on. You can use this sequence as a quick warm-up, or as a standalone circuit depending on your conditioning level.
1a) Deadbug 1-3 x 8/sd
1b) Birddog 1-3 x 8/sd
1c) Glute Bridge 1-3 x 10-12
1d) Side Bridge Clam 1-3 x8-10/sd
Then when you perform exercises such as your Squats, Deadlifts, Lunges, Step-Ups, etc., focus on what these exercises do for you. Keep your abs engaged like you would for the Dead Bug and Bird Dog, and then use your glutes as you would with the Glute Bridge and Side Bridge Clam. Boom!